Periodontal disease is a combination of inflammation and infection of some or all of the tooth support structures (gingiva, cementum, periodontal ligament, alveolar bone and other tissues surrounding the teeth). Gingivitis (gums) and periodontitis (gums and bone) are the two main forms of periodontal disease. According to National Oral Information distributed by the National Institute of Dental and Craniofacial Research, an estimated 80 percent of American adults currently have some form of periodontal disease. Periodontal disease is initiated when a pellicle forms on a clean tooth or teeth. This pellicle attracts aerobic gram-positive bacteria (mostly actinomyces and streptococci), which adhere to the tooth forming plaque. Within days the plaque thickens, the underlying bacteria run out of oxygen and anaerobic motile rods and spirochetes begin to populate the subgingival area. Endotoxins released by the anaerobic bacteria cause inflammation, gum tissue destruction and even bone loss. There are four primary stages of periodontal disease that can be characterized as indicated below. The destructive impact of periodontal disease goes beyond dental hygiene and health, in that microscopic lesions resulting from periodontal disease have been found in the liver, kidneys, and brain of some affected persons.
Four Stages of Periodontal DiseaseGrade 1InflammationGrade 2Inflammation, edema, gingival bleeding upon probingGrade 3Inflammation, edema, gingival bleeding upon probing, pustulardischarge - slight to moderate bone lossGrade 4Inflammation, edema, gingival bleeding upon probing, pustulardischarge, mobility - severe bone loss
The inflammation resulting from periodontal disease is mainly related to two biological systems:—the eicosanoid system and the cytokine system. The release and metabolism of arachidonic acid (AA) from the cell membrane results in the generation of pro-inflammatory metabolites by several different pathways. Two of the most important pathways to inflammation are mediated by the enzymes lipoxygenase (LOX) and cyclooxygenase (COX). These are parallel pathways that result in the generation of leukotrienes and prostaglandins, respectively, which play important roles in the initiation and progression of the inflammatory response. These vasoactive compounds are chemotaxins, which both promote infiltration of inflammatory cells into gum tissue and serve to prolong the inflammatory response that may lead to bone loss. Consequently, the enzymes responsible for generating these mediators of inflammation can be targeted to develop therapeutic agents to prevent and treat diseases and conditions related to the mouth, teeth and gums.
The cytokine system is a very potent force in homeostasis when activation of the network is local and the cytokines act vicinally in surface-bound or diffusible form. But when cytokine production is sustained and/or systemic, cytokines contribute to the signs, symptoms, and pathology of inflammatory, infectious, autoimmune, and malignant diseases. TNF-α is a potent pleiotropic cytokine produced by macrophages, neutrophiles, fibroblasts, keratinocytes, NK cells T and B cell and tumor cells. IL-1β, together with TNF-α, plays a central role in inflammatory responses. Administration of antagonists, such as IL-1ra (IL-1 receptor antagonist), soluble fragment of IL-1 receptor, or monoclonal antibodies to TNF-α and soluble TNF receptor, all block various acute and chronic responses in animal models of inflammatory diseases. Nuclear factor kappa B (NFκB) is a transcription factor that controls gene expression of interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNFα), interleukin-6 (IL-6) and many other proteins. Some of these antagonists are beginning to be utilized as anti-inflammatory agents in diseases such as sepsis, periodontal diseases and rheumatoid arthritis. (Dinarello (2004) Curr Opin Pharmacol. 4:378-385). Anti-TNF-α antibodies were not only found to induce striking remissions in rheumatoid arthritis, but also to reduce tissue inflammation in Crohn's disease, an inflammatory bowel disease (Maini and Feldmann. (2002) Arthritis Res. 4 Suppl 2: S22-8).
Periodontal ligament (PDL) cells exhibit osteoblast-like features and are capable of differentiating into cells of either cementogenic or osteogenic lineage. These cells are crucial for the maintenance of the integrity and regeneration of the periodontium (Somerman et al. (1990) Arch Oral Biol. 35: 241-47; Pitaru et al. (1994) J Periodontal Res. 29:81-94). Chronic infections in the periodontium, initiated by bacterial colonization, induce synthesis of pro-inflammatory cytokines, which can potentially affect PDL cell phenotype and function. These cytokines not only activate and recruit immune cells to the site of infection (Le and Vilcek (1987) J. Immunol. 139: 3330; Kunkel et al (1994) Ann. N.Y. Acad. Sci. 730:134), but also induce loss of supporting bone and ligamentous attachment (Pitaru et al. (1994) J Periodontal Res. 29:81-94). TNFα, for example, has been shown to modulate the PDL cell osteoblast-like phenotype and functions (Agarwal et al. (1998) Infect. Immun. 66:932-937). Additionally, TNFα and IL-1β change the phenotypic characteristics of osteoblasts by down-regulation of alkaline phosphatase (Kuroki et al. (1994) Rheumatology 33:224) and by the modulation of collagen, collagenase, proteoglycan, and prostaglandin syntheses (Agarwal et al. (1998) Infect. Immun. 66:932-937).
In the isolated PDL cells, IL-1β induces phenotypic changes (Agarwal et al. (1998) Infect. Immun. 66:932-937). PDL cells from healthy periodontium do not recognize bacterial lipopolysaccharide (LPS) nor do they elicit pro-inflammatory cytokines in response to LPS. Following IL-1β treatment, PDL cells lose their osteoblast-like characteristics while assuming a new LPS-responsive phenotype. Thus, IL-1β is an important regulator of PDL cell function and directs these cells to participate actively in an immune response during infections. IL-1β stimulates bone resorption and inhibits bone formation (Stashenko et al. (1987) J Bone Miner Res. 2:559-65; Nguyen et al. (1991) Lymphokine Cytokine Res. 10:15-21; Tatakis (1993) J Periodontol (1991) 64:416-31). In addition, IL-1β synergizes the bone-resorptive actions of TNF-α (Bertolini et al. (1986) Nature 319:516-18; van der Pluijm et al. (1991) Endocrinology 129:1596). Another important activity of IL-1β in the pathological process of periodontitis is to induce the production of matrix metalloproteinases (MMPs) (Havemose-Poulsen and Holmstrup (1997) Crit. Rev. Oral. Biol. Med 8:217). IL-1β gives rise to an elevated level of procollagenase in both gingival fibroblasts and PDL cells (Meikle et al. (1989) J Periodontal Res. 24:207-13; Lark et al. (1990) Connect Tissue Res. 25:49-65; Tewari et al. (1994) Arch Oral Biol. 39 657-64). In addition, IL-1β stimulates plasminogen activator in gingival fibroblasts, resulting in the generation of plasmin, which is an activator of several matrix metalloproteinases (Mochan et al. (1988) J Periodontal Res. 23:28-32). Furthermore, Stashenko and co-workers reported a positive correlation between IL-1β levels in gingival tissues and recent attachment loss (Stashenko et al. (1991) J Clin Periodontol 18:548-54).
TNFα is another key mediator of immune and inflammatory responses and has been found in measurable quantities in the areas of active periodontal inflammation (Rossomando et al. (1990) Arch Oral Biol. 35:431-34; Stashenko et al. (1991) J Clin Periodontol 18:548-54). TNFα changes the osteoblastic features of PDL cells (Quintero et al. (1995) J. Dent. Res. 74:1802). This is substantiated by their ability to express other pro-inflammatory cytokines, such as IL-1β, IL-6, and IL-8, in response to LPS. TNFα induces the secretion of collagenase by fibroblasts, resorption of cartilage and bone, and has been implicated in the destruction of periodontal tissue in periodontitis (Elias et al. (1987) J. Immunol. 138:3812; Meikle et al. (1989) J Periodontal Res. 24:207-13; Chaudhary et al. (1992) Endocrinology 130:2528). In resting macrophages, TNFα induces the synthesis of IL-1β and prostaglandin E2. TNF-α also activates osteoclasts and thus induces bone resorption. TNF-α has synergistic effects with the bone-resorptive actions of IL-1β ((van der Pluijm et al. (1991) Endocrinology 129:1596; Bertolini et al. (1986) Nature 319:516-8; Johnson et al. (1989) Endocrinology 124:1424).
In inflammatory periodontal lesions, a variety of cell types-such as T-cells, macrophages, endothelial cells, and fibroblasts-were shown to have increased IL-6 expression at both the mRNA and protein levels (Kono et al. (1991) J. Immunol. 146:1812; Matsuki et al (1992) Immunology 76:42-47; Fujihashi et al. (1993) Am. J. Pathol. 142:1239; Yarnazaki et al. (1994) J Oral Pathol Med. 23:347-53). Since IL-6 is of particular importance in human B cell responses, it has been speculated that the expansion of B-cells/plasma cells seen in periodontitis lesions may result from an increased production of IL-6 at diseased sites (Fujihashi et al (1993) J Periodontol 64:400-406). Additionally, IL-6 plays an important role in the local regulation of bone turnover (Lowik et al. (1989) Biochem Biophys Res Commun. 162:1546-52; Ishimi et al. (1990) J. Immunol. 145:3297; Kurihara et al. (1990) J. Immunol. 144:4226) and appears to be essential for bone loss caused by estrogen deficiency (Horowitz (1993) J Bone Miner Res. 8:1163-71). In vitro studies also demonstrated that simultaneous treatment of mouse osteoblastic cells and bone marrow cells with IL-6 and soluble IL-6 receptor strikingly induced osteoclast formation (Tamura et al. (1993) PNAS 90:11924). Furthermore, it was also suggested that IL-6 may act as an autocrine and/or paracrine factor in bone resorption in pathologic states by stimulating the formation of osteoclasts and the activation of osteoclastic bone resorption (Ohsaki et al. (1992) Endocrinology 131: 2229). These findings imply the involvement of IL-6 in the pathogenesis of periodontal tissue destruction in periodontitis.
Inhibition of the COX enzyme is the mechanism of action attributed to most non-steroidal anti-inflammatory drugs (NSAIDS). There are two distinct isoforms of the COX enzyme (COX-1 and COX-2), which share approximately 60% sequence homology, but differ in expression profiles and function. COX-1 is a constitutive form of the enzyme that has been linked to the production of physiologically important prostaglandins, which help regulate normal physiological functions, such as platelet aggregation, protection of cell function in the stomach and maintenance of normal kidney function. (Dannhardt and Kiefer (2001) Eur. J. Med. Chem. 36:109-26). The second isoform, COX-2, is a form of the enzyme that is inducible by pro-inflammatory cytokines, such as interleukin-1β (IL-1β) and other growth factors. (Herschmann (1994) Cancer Metastasis Rev. 134:241-56; Xie et al. (1992) Drugs Dev. Res. 25:249-65). This isoform catalyzes the production of prostaglandin E2 (PGE2) from arachidonic acid (AA). Inhibition of COX is responsible for the anti-inflammatory activity of conventional NSAIDs.
Inhibitors that demonstrate dual specificity for COX and LOX would have the obvious benefit of inhibiting multiple pathways of arachidonic acid metabolism. Such inhibitors would block the inflammatory effects of prostaglandins (PG), as well as, those of multiple leukotrienes (LT) by limiting their production. This includes the vasodilation, vasopermeability and chemotactic effects of PGE2, LTB4, LTD4 and LTE4, also known as the slow reacting substance of anaphalaxis. Of these, LTB4 has the most potent chemotactic and chemokinetic effects. (Moore (1985) in Prostanoids: pharmacololical physiological and clinical relevance, Cambridge University Press, N.Y., pp. 229-230).
Because the mechanism of action of COX inhibitors overlaps that of most conventional NSAID's, COX inhibitors are used to treat many of the same symptoms, including pain and swelling associated with inflammation in transient conditions and chronic diseases in which inflammation plays a critical role. However, most of the known NSAIDs are not suitable for periodontal diseases due to their poor solubility and bioavailability.
Current methods for treating periodontal disease are limited with control of the infection being the primary goal (Genco et al. (1990) in Contenporary Periodontics, The C.V. Mosby Company, St. Louis, pp. 361-370). Common anti-microbial or anti-plaque agents include chlorhexidine, Triclosan, stannous fluoride, Listerine, hydrogen peroxide, cetylpyridimiun chloride and sanguinarine alkaloids. Prescription anti-microbial mouth rinse, antiseptic chip, antibiotic gel/micro-spheres and enzyme suppressant-doxycycline are the preferred non-mechanical/physical options to treat and control periodontal disease. Applicant is unaware of any reports of a formulation combining Free-B-Ring-Flavonoids and flavans as the primary biologically active components targeting the eicosanoid and cytokine pathways for the treatment of oral diseases and conditions.
Flavonoids or bioflavonoids are a widely distributed group of natural products, which have been reported to have antibacterial, anti-inflammatory, antiallergic, antimutagenic, antiviral, antineoplastic, anti-thrombic and vasodilatory activity. The structural unit common to this group of compounds includes two benzene rings on either side of a 3-carbon ring as illustrated by the following general structural formula:
Various combinations of hydroxyl groups, sugars, oxygen and methyl groups attached to this general three ring structure create the various classes of flavonoids, which include flavanols, flavones, flavan-3-ols (catechins), anthocyanins and isoflavones.
Free-B-Ring flavones and flavonols are a specific class of flavonoids, which have no substituent groups on the aromatic B ring (referred to herein as Free-B-Ring flavonoids), as illustrated by the following general structure:

wherein
R1, R2, R3, R4, and R5 are independently selected from the group consisting of —H, —OH, —SH, OR, —SR, —NH2, —NHR, —NR2, —NR3+X−, a glycoside of a single or combination of multiple sugars, wherein said glycoside is linked to the 7-hydroxy chromone by a carbon, oxygen, nitrogen or sulfur, and wherein said single or combination of multiple sugars include, but are not limited to aldopentoses, methyl-aldopentose, aldohexoses, ketohexose and their chemical derivatives thereof;
wherein
R is an alkyl group having between 1-10 carbon atoms; and
X is selected from the group of pharmaceutically acceptable counter anions including, but not limited to hydroxyl, chloride, iodide, fluoride, sulfate, phosphate, acetate, carbonate, etc.
Free-B-Ring flavonoids are relatively rare. Out of 9,396 flavonoids synthesized or isolated from natural sources, only 231 Free-B-Ring flavonoids are known (The Combined Chemical Dictionary, Chapman & Hall/CRC, Version 5:1 June 2001). Free-B-Ring flavonoids have been reported to have diverse biological activity. Typically, flavonoids have been tested for biological activity randomly based upon their availability. Occasionally, the requirement of substitution on the B-ring has been emphasized for specific biological activity, such as the B-ring substitution required for high affinity binding to p-glycoprotein (Boumendjel et al. (2001) Bioorg. Med. Chem. Lett. 11(1):75-77); cardiotonic effect (Itoigawa et al. (1999) J. Ethnopharmacol. 65(3): 267-272), protective effect on endothelial cells against linoleic acid hydroperoxide-induced toxicity (Kaneko and Baba (1999) Biosci Biotechnol. Biochem 63(2):323-328), COX-1 inhibitory activity (Wang (2000) Phytomedicine 7:15-19) and prostaglandin endoperoxide synthase (Kalkbrenner et al (1992) Pharmacology 44(1):1-12). Few publications have mentioned the significance of the unsubstituted B ring of the Free-B-Ring flavonoids. One example is the use of 2-phenyl flavones, which inhibit NADPH quinone acceptor oxidoreductase, as potential anticoagulants. (Chen et al. (2001) Biochem. Pharmacol. 61(11):1417-1427).
The mechanism of action of the anti-inflammatory activity of various Free-B-Ring flavonoids has been controversial. The anti-inflammatory activity of the Free-B-Ring flavonoids, chrysin (Liang et al. (2001) FEBS Lett. 496(1):12-18), wogonin (Chi et al. (2001) Biochem. Pharmacol. 61:1195-1203) and halangin (Raso et al. (2001) Life Sci. 68(8):921-931), has been associated with the suppression of inducible cyclooxygenase and nitric oxide synthase via activation of peroxisome proliferator activated receptor gamma (PPARγ) and influence on degranulation and AA release. (Tordera et al. (1994) Z. Naturforsch [C] 49:235-240). It has been reported that oroxylin, baicalein and wogonin inhibit the activity of 12-lipoxygenase without affecting cyclooxygenase. (You et al. (1999) Arch. Pharm. Res. 22(1):18-24). More recently, the anti-inflammatory activity of wogonin, baicalin and baicalein has been reported as occurring via inhibition of inducible nitric oxide synthase and cox-2 gene expression induced by nitric oxide inhibitors and lipopolysaccharide. (Chen et al. (2001) Biochem. Pharmacol. 61(11):1417-1427). It has also been reported that oroxylin acts via suppression of NFκB activation. (Chen et al. (2001) Biochem. Pharmacol. 61(11):1417-1427). Finally, wogonin reportedly inhibits inducible PGE2 production in macrophages. (Wakabayashi and Yasui (2000) Eur. J. Pharmacol. 406(3):477-481).
The Chinese medicinal plant, Scuttellaria baicalensis contains significant amounts of Free-B-Ring flavonoids, including baicalein, baicalin, wogonin and baicalenoside. Traditionally, this plant has been used to treat a number of conditions including clearing away heat, purging fire, dampness-warm and summer fever syndromes; polydipsia resulting from high fever; carbuncle, sores and other pyogenic skin infections; upper respiratory infections, such as acute tonsillitis, laryngopharyngitis and scarlet fever; viral hepatitis; nephritis; pelvitis; dysentery; hematemesis and epistaxis. This plant has also traditionally been used to prevent miscarriage. (Encyclopedia of Chinese Traditional Medicine, ShangHai Science and Technology Press, ShangHai, China, 1998). Clinically Scutellaria is now used to treat conditions such as pediatric pneumonia, pediatric bacterial diarrhea, viral hepatitis, acute gallbladder inflammation, hypertension, topical acute inflammation, resulting from cuts and surgery, bronchial asthma and upper respiratory infections. (Encyclopedia of Chinese Traditional Medicine, ShangHai Science and Technology Press, ShangHai, China, 1998). The pharmacological efficacy of Scuttellaria roots for treating bronchial asthma is reportedly related to the presence of Free-B-Ring flavonoids and their suppression of eotaxin associated recruitment of eosinophils. (Nakajima et al. (2001) Planta Med. 67(2):132-135).
To date, a number of naturally occurring Free-B-Ring flavonoids have been commercialized for varying uses. For example, liposome formulations of Scutellaria extracts have been utilized for skin care (U.S. Pat. Nos. 5,643,598; 5,443,983). Baicalin has been used for preventing cancer, due to its inhibitory effects on oncogenes (U.S. Pat. No. 6,290,995). Baicalin and other compounds have been used as antiviral, antibacterial and immunomodulating agents (U.S. Pat. No. 6,083,921 and WO98/42363) and as natural anti-oxidants (WO98/49256 and Poland Pub. No. 9,849,256). Flavonoids formulates with terpenoids have been used as inhibitors of surface-bound glusosyltransferase for treating and inhibiting dental caries (US#20040057908). Japanese Pat. No. 63027435 describes the extraction, and enrichment of baicalein and Japanese Pat. No. 61050921 describes the purification of baicalin.
U.S. application Ser. No. 10/091,362, filed Mar. 1, 2002, entitled “Identification of Free-B-Ring Flavonoids as Potent COX-2 Inhibitors,” and U.S. application Ser. No. 10/427,746, filed Jul. 22, 2003, entitled “Formulation of a Mixture of Free-B-Ring Flavonoids and Flavans as a Therapeutic Agent” disclose a method for inhibiting the cyclooxygenase enzyme COX-2 by administering a composition comprising a Free-B-Ring flavonoid or a composition containing a mixture of Free-B-Ring flavonoids to a host in need thereof. This is the first report of a link between Free-B-Ring flavonoids and COX-2 inhibitory activity. These applications are specifically incorporated herein by reference in their entirety.
Flavans include compounds illustrated by the following general structure:

wherein
R1, R2, R3, R4 and R5 are independently selected from the group consisting of H, —OH, —SH, —OCH3, —SCH3, —OR, —SR, —NH2, —NRH, —NR2, —NR3+X−, esters of the mentioned substitution groups, including, but not limited to, gallate, acetate, cinnamoyl and hydroxyl-cinnamoyl esters, trihydroxybenzoyl esters and caffeoyl esters, and their chemical derivatives thereof, a glycoside of a single or combination of multiple sugars, wherein said glycoside is linked to the 7-hydroxy chromone by a carbon, oxygen, nitrogen or sulfur, and wherein said single or combination of multiple sugars include, but are not limited to aldopentoses, methyl-aldopentose, aldohexoses, ketohexose and their chemical derivatives thereof and other polymerized flavans;
wherein
R is an alkyl group having between 1-10 carbon atoms; and
X is selected from the group of pharmaceutically acceptable counter anions including, but not limited to hydroxyl, chloride, iodide, sulfate, phosphate, acetate, fluoride, and carbonate, etc.
Catechin is a flavan, found primarily in green tea, having the following structure:
Catechin works both alone and in conjunction with other flavonoids found in tea, and has both antiviral and antioxidant activity. Catechin has been shown to be effective in the treatment of viral hepatitis. It also appears to prevent oxidative damage to the heart, kidney, lungs and spleen and has been shown to inhibit the growth of stomach cancer cells.
Catechin and its isomer epicatechin inhibit prostaglandin endoperoxide synthase with an IC50 value of 40 μM. (Kalkbrenner et al. (1992) Pharmacol. 44:1-12). Commercially available pure (+)-catechin inhibits COX-1 with an IC50 value of around 183 to 279 μM depending upon the experimental conditions, with no selectivity for COX-2. (Noreen et al. (1998) J. Nat. Prod. 61:1-7). Green tea catechin, when supplemented into the diets of Sprague Dawley male rats, lowered the activity level of platelet PLA2 and significantly reduced platelet cyclooxygenase levels. (Yang et al. (1999) J. Nutr. Sci. Vitaminol. 45:337-346). Catechin and epicatechin reportedly weakly suppress cox-2 gene transcription in human colon cancer DLD-1 cells (IC50=415.3 μM). (Mutoh et al. (2000) Jpn. J. Cancer Res. 91:686-691). The neuroprotective ability of (+)-catechin from red wine results from the antioxidant properties of catechin, rather than inhibitory effects on intracellular enzymes, such as cyclooxygenase, lipoxygenase, or nitric oxide synthase (Bastianetto et al. (2000) Br. J. Pharmacol. 131:711-720). Catechin derivatives purified from green and black tea, such as epigallocatechin-3-gallate (EGCG), epigallocatechin (EGC), epicatechin-3-gallate (ECG), and theaflavins showed inhibition of cyclooxygenase and lipoxygenase dependent metabolism of AA in human colon mucosa and colon tumor tissues (Hong et al. (2001) Biochem. Pharmacol. 62:1175-1183) and induce cox-2 expression and PGE2 production (Park et al. (2001) Biochem. Biophys. Res. Commun. 286:721-725).
Acacia is a genus of leguminous trees and shrubs. The genus Acacia includes more than 1000 species belonging to the family of Leguminosae and the subfamily of Mimosoideae. Acacias are distributed worldwide in tropical and subtropical areas of Central and South America, Africa, parts of Asia, as well as, Australia, which has the largest number of endemic species. To date, approximately 330 compounds have been isolated from various Acacia species. Flavonoids are the major class of compounds isolated from Acacias. Approximately 180 different flavonoids have been identified, 111 of which are flavans. Terpenoids are second largest class of compounds isolated from species of the Acacia genus, with 48 compounds having been identified. Other classes of compounds isolated from Acacia include, alkaloids (28), amino acids/peptides (20), tannins (16), carbohydrates (15), oxygen heterocycles (15) and aliphatic compounds (10). (Buckingham, The Combined Chemical Dictionary, Chapman & Hall CRC, version 5:2, December 2001).
Phenolic compounds, particularly flavans are found in moderate to high concentrations in all Acacia species. (Abdulrazak et al. (2000) Journal of Animal Sciences. 13:935-940). Historically, most of the plants and extracts of the Acacia genus have been utilized as astringents to treat gastrointestinal disorders, diarrhea, indigestion and to stop bleeding. (Vautrin (1996) Universite Bourgogne (France) European abstract 58-01C:177; Saleem et al. (1998) Hamdard Midicus. 41:63-67). The extract from the bark of Acacia has been patented in Japan for external use as a whitening agent (Abe, JP 10025238), as a glucosyl transferase inhibitor for dental applications (Abe, JP 07242555), as a protein synthesis inhibitor (Fukai, JP 07165598), as an active oxygen scavenger for external skin preparations (Honda, JP 07017847, Bindra U.S. Pat. No. 6,126,950), and as an inhibitor of hyaluronidase to prevent inflammation, pollinosis and cough (Ogura, JP 07010768).
The Uncaria genus, includes 34 species many of which are well known as medicinal plants. Uncaria plants have been utilized by different cultures for treatment of wounds, and ulcers, fevers, headaches, gastrointestinal illnesses and microbial/gungal infections. Uncaria plants contain significant amounts of catechin and other flavones. Other components that have been reported in Uncaria genus include alkaloids, terpenes, quinovic acid glycosides, coumarins, and flavonoids. Uncaria gambir is a species common in Malaysia, Singapore, India and other South East Asian countries. Catechins are major components in the whole plant of Uncaria gambir. 